25 results on '"Herrera-Montalvo LA"'
Search Results
2. 155 Tumor histology as prognostic in locally advanced cervical cancer
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Cantu, D, Gallardo-Alvardo, L, Perez-Plasencia, C, Herrera-Montalvo, LA, Millan-Catalan, O, and Perez-Montiel, MD
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- 2019
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3. 155 Tumor histology as prognostic in locally advanced cervical cancer
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Cantu, D, primary, Gallardo-Alvardo, L, additional, Perez-Plasencia, C, additional, Herrera-Montalvo, LA, additional, Millan-Catalan, O, additional, and Perez-Montiel, MD, additional
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- 2019
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4. 172 Gastric-type endocervical adenocarcinoma (GAS): a comparative analysis
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Cantu, D, primary, Gallardo-Alvarado, L, additional, Perez-Plasencia, C, additional, Perez-Montiel, MD, additional, Millan-Catalan, O, additional, and Herrera-Montalvo, LA, additional
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- 2019
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5. A Molecular Characterization of the Allelic Expression of the BRCA1 Founder Δ9-12 Pathogenic Variant and Its Potential Clinical Relevance in Hereditary Cancer.
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Dominguez-Ortiz J, Álvarez-Gómez RM, Montiel-Manríquez R, Cedro-Tanda A, Alcaraz N, Castro-Hernández C, Bautista-Hinojosa L, Contreras-Espinosa L, Torres-Maldonado L, Fragoso-Ontiveros V, Sánchez-Contreras Y, González-Barrios R, Fuente-Hernández MA, Mejía-Aguayo ML, Juárez-Figueroa U, Padua-Bracho A, Sosa-León R, Obregon-Serrano G, Vidal-Millán S, Núñez-Martínez PM, Pedroza-Torres A, Nicasio-Arzeta S, Rodríguez A, Luna F, Cisneros-Soberanis F, Frías S, Arriaga-Canon C, and Herrera-Montalvo LA
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- Humans, Female, Middle Aged, Genetic Predisposition to Disease, Adult, Founder Effect, Exons genetics, Breast Neoplasms genetics, Heterozygote, Mutation, Mexico, Ovarian Neoplasms genetics, Clinical Relevance, BRCA1 Protein genetics, Alleles, Hereditary Breast and Ovarian Cancer Syndrome genetics
- Abstract
Hereditary breast and ovarian cancer (HBOC) syndrome is a genetic condition that increases the risk of breast cancer by 80% and that of ovarian cancer by 40%. The most common pathogenic variants (PVs) causing HBOC occur in the BRCA1 gene, with more than 3850 reported mutations in the gene sequence. The prevalence of specific PVs in BRCA1 has increased across populations due to the effect of founder mutations. Therefore, when a founder mutation is identified, it becomes key to improving cancer risk characterization and effective screening protocols. The only founder mutation described in the Mexican population is the deletion of exons 9 to 12 of BRCA1 ( BRCA1
Δ9-12 ), and its description focuses on the gene sequence, but no transcription profiles have been generated for individuals who carry this gene. In this study, we describe the transcription profiles of cancer patients and healthy individuals who were heterozygous for PV BRCA1Δ9-12 by analyzing the differential expression of both alleles compared with the homozygous BRCA1 control group using RT-qPCR, and we describe the isoforms produced by the BRCA1 wild-type and BRCA1Δ9-12 alleles using nanopore long-sequencing. Using the Kruskal-Wallis test, our results showed a similar transcript expression of the wild-type allele between the healthy heterozygous group and the homozygous BRCA1 control group. An association between the recurrence and increased expression of both alleles in HBOC patients was also observed. An analysis of the sequences indicated four wild-type isoforms with diagnostic potential for discerning individuals who carry the PV BRCA1Δ9-12 and identifying which of them has developed cancer.- Published
- 2024
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6. SARS-CoV-2 seroprevalence and respiratory disease disability claims in Mexico City Metropolitan Area.
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Barros-Sierra D, Zepeda-Tello R, Tamayo-Ortiz M, Gutiérrez-Díaz HO, Pérez-Chávez VA, Rosa-Parra JA, Nieto-Barajas LE, Méndez-Aranda M, Herrera-Montalvo LA, and Hernández-Ávila M
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- Humans, SARS-CoV-2, Mexico epidemiology, Seroepidemiologic Studies, Antibodies, Viral, COVID-19 epidemiology, Epidemics
- Abstract
Objective: To characterize the impact of SARS-CoV-2 infection in workers from an essential large-scale company in the Greater Mexico City Metropolitan Area using point prevalence of acute infection, point prevalence of past infection through serum antibodies and respiratory disease short-term disability claims (RD-STDC)., Materials and Methods: Four randomized surveys, three during 2020 before and one after (December 2021) vaccines' availability., Outcomes: point prevalence of acute infection through saliva PCR (polymerase chain reaction) testing, point prevalence of past infection through serum antibodies against Covid-19, RD-STDC and prevalence of symptoms during the previous six months., Results: Prevalence of SARS-CoV-2 cases was 1.29-4.88%, on average, a quarter of participants pre-vaccination were seropositive; over half of participants with a RD-STDC had antibodies. The odds of having antibodies were 6-7 times more among workers with an RD-STDC., Conclusions: High antibody levels against Covid-19 in this study population reflects that coverage is high among workers in this industry. STDCs are a useful tool to track workplace epidemics.
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- 2023
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7. Prevalence of SARS-CoV-2 antibodies in cancer patients and healthcare workers vaccinated with two doses of BNT162b2 or AZD122. A propensity analysis.
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Villaseñor-Echavarri R, De-la-Rosa-Martinez D, Frías-Jimenez E, Martin-Onraet A, Cruz-Cruz A, Herrera-Montalvo LA, and Vilar-Compte D
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- Humans, Prevalence, BNT162 Vaccine, SARS-CoV-2, Health Personnel, COVID-19 epidemiology, COVID-19 prevention & control, Neoplasms
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Background: Vaccination is the most effective intervention for reducing the burden of SARS-CoV-2-related disease; however, gaps in knowledge regarding cancer patients (CPs) immune response persist., Objectives: To evaluate the humoral response (anti-S antibodies) in CPs and healthcare workers (HCWs) vaccinated with two doses of BNT162b2 or AZD122 vaccines., Material and Methods: Polyspecific anti-SARS-CoV-2 spike protein (anti-S) antibodies were quantified, and a 1:1 propensity score was used to balance baseline characteristics. Multiple logistic regressions were carried out to evaluate the effect of humoral response-related variables., Results: One-hundred and twenty-seven CPs (22%) and 439 HCWs (78%) were included. Both populations developed anti-S antibodies in response to vaccination. The mRNA-based vaccine (BNT162b2) was associated with higher odds of having anti-S antibody titers ≥ 1,000 U/mL, while active cancer was related to a lower probability of developing high antibody titers., Conclusions: The BNT162b2 vaccine was associated with a higher humoral response. It is necessary for more information and vaccination strategies to be available for immunosuppressed patients in order to select the best biologics for this population based on individual characteristics., (Copyright: © 2023 Permanyer.)
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- 2023
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8. Cancer Genomics.
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Fonseca-Montaño MA, Blancas S, Herrera-Montalvo LA, and Hidalgo-Miranda A
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- Humans, DNA Copy Number Variations, Mutation, Genomics, Neoplasms genetics
- Abstract
In the past decade, genomics has fundamentally changed our view of cancer biology, allowing comprehensive analyses of mutations, copy number alterations, structural variants, gene expression and DNA methylation profiles in large-scale studies across different cancer types. Efforts like The Cancer Genome Atlas (TCGA) and the International Cancer Genome Consortium (ICGC) have fostered international collaborations for cancer genomic analyses and have generated public databases that give scientists around the world access to thoroughly curated data, which have been extensively used as a tool for further hypothesis driven research on several aspects of cancer biology. In parallel, some of these findings are being translated into specific clinical benefits for cancer patients. In this review, we provide a brief historical description of the evolution of international public cancer genome projects and related databases, as well as we discuss about their impact on general cancer research., Competing Interests: Conflict of Interest None of the authors have any kind of conflict of interests to declare., (Copyright © 2022. Published by Elsevier Inc.)
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- 2022
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9. A Previously Unrecognized Molecular Landscape of Lynch Syndrome in the Mexican Population.
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Padua-Bracho A, Velázquez-Aragón JA, Fragoso-Ontiveros V, Nuñez-Martínez PM, Mejía Aguayo ML, Sánchez-Contreras Y, Ramirez-Otero MA, De la Fuente-Hernández MA, Vidal-Millán S, Wegman-Ostrosky T, Pedroza-Torres A, Arriaga-Canon C, Herrera-Montalvo LA, and Alvarez-Gómez RM
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- DNA Mismatch Repair genetics, DNA-Binding Proteins genetics, Female, Germ-Line Mutation, Humans, Immune Checkpoint Inhibitors, Mexico epidemiology, MutS Homolog 2 Protein genetics, Retrospective Studies, Colorectal Neoplasms, Hereditary Nonpolyposis diagnosis, Colorectal Neoplasms, Hereditary Nonpolyposis epidemiology, Colorectal Neoplasms, Hereditary Nonpolyposis genetics
- Abstract
Lynch syndrome (LS) is the main hereditary colorectal cancer syndrome. There have been few reports regarding the clinical and molecular characteristics of LS patients in Latin America; this is particularly true in the Mexican population, where no information is available. The present study aims to describe the clinical and molecular spectrum of variants in a cohort of patients diagnosed with LS in Mexico. We present a retrospective analysis of 412 patients with suspected LS, whose main site of cancer diagnosis was the colon (58.25%), followed by the endometrium (18.93%). Next-generation sequencing analysis, with an extensive multigene panel, showed that 27.1% (112/414) had a variant in one of the genes of the mismatch repair pathway (MMR); 30.4% (126/414) had a variant in non-MMR genes such as CHEK2 , APC , MUTYH , BRCA1 , and BRCA2 ; and 42.5% (176/414) had no genetic variants. Most of the variants were found in MLH1 . Pathogenic variants (PVs) in MMR genes were identified in 65.7% (96/146) of the total PVs, and 34.24% (45/146) were in non-MMR genes. Molecular and clinical characterization of patients with LS in specific populations allowed personalized follow-up, with the option for targeted treatment with immune checkpoint inhibitors and the development of public health policies. Moreover, such characterization allows for family cascade testing and consequent prevention strategies.
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- 2022
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10. microRNA Profile Associated with Positive Lymph Node Metastasis in Early-Stage Cervical Cancer.
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Barquet-Muñoz SA, Pedroza-Torres A, Perez-Plasencia C, Montaño S, Gallardo-Alvarado L, Pérez-Montiel D, Herrera-Montalvo LA, and Cantú-de León D
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- Female, Gene Expression Profiling, Humans, Lymphatic Metastasis, Prognosis, MicroRNAs genetics, MicroRNAs metabolism, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms genetics, Uterine Cervical Neoplasms surgery
- Abstract
Lymph node metastasis (LNM) is an important prognostic factor in cervical cancer (CC). In early stages, the risk of LNM is approximately 3.7 to 21.7%, and the 5-year overall survival decreases from 80% to 53% when metastatic disease is identified in the lymph nodes. Few reports have analyzed the relationship between miRNA expression and the presence of LNM. The aim of this study was to identify a subset of miRNAs related to LNM in early-stage CC patients. Formalin-fixed paraffin-embedded tissue blocks were collected from patients with early-stage CC treated by radical hysterectomy with lymphadenectomy. We analyzed samples from two groups of patients-one group with LNM and the other without LNM. Global miRNA expression was identified by microarray analysis, and cluster analysis was used to determine a subset of miRNAs associated with LNM. Microarray expression profiling identified a subset of 36 differentially expressed miRNAs in the two groups (fold change (FC) ≥ 1.5 and p < 0.01). We validated the expression of seven miRNAs; miR-487b, miR-29b-2-5p, and miR-195 were underexpressed, and miR-92b-5p, miR-483-5p, miR-4534, and miR-548ac were overexpressed according to the microarray experiments. This signature exhibited prognostic value for identifying early-stage CC patients with LNM. These findings may help detect LNM that cannot be observed in imaging studies.
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- 2022
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11. Cancer Prevention Behaviors in Workers of a Referral Cancer Center in Mexico City: A Pilot Study on Early Detection Awareness for Cancer.
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Reynoso-Noverón N, Chang S, Herrera-Montalvo LA, and Meneses-García A
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- Cross-Sectional Studies, Female, Humans, Infant, Newborn, Male, Mexico epidemiology, Pilot Projects, Referral and Consultation, Early Detection of Cancer, Neoplasms diagnosis, Neoplasms epidemiology, Neoplasms prevention & control
- Abstract
Background: Prevention strategies for cancer are necessary. Health workers who often serve as role models bear responsibility for prevention counseling and programs. However, whether their habits and behaviors reflect prevention goals are unknown. We describe the prevalence of cancer risk factors and prevention behaviors in health workers of a referral cancer center in Mexico City., Methods: Cross-sectional study in which workers of the National Cancer Institute were invited to participate in a prevention program, risk factor survey, and nutrition, psychological, and genetic counseling were included. The likelihood of cancer was calculated based on the presence of risk factors. Factors associated with prevention behaviors were identified by logistic regression., Results: We recruited 301 workers; 77% were women. The median self-reported BMI was 26.4 kg/m
2 , 9.97% smoked, 78% drank alcohol, and 89% did not get at least 150 min/week of physical activity. In women, age (OR = 1.3 95%CI 1.01-1.06) and physical activity of 150 min/week (OR = 2.52 95% CI 1.28-4.96) were associated with cancer prevention behaviors. No risk factors were associated with healthy behaviors among men., Conclusion: Health workers may have unhealthy lifestyles and behaviors, is essential to create supportive environments to promote cancer prevention counseling and programs effectively.- Published
- 2022
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12. Genotoxicity of Marijuana in Mono-Users.
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Fabian-Morales E, Fernández-Cáceres C, Gudiño A, Andonegui Elguera MA, Torres-Arciga K, Escobar Arrazola MA, Tolentino García L, Alfaro Mora YE, Oliva-Rico DA, Cáceres Gutiérrez RE, Domínguez Ortíz J, Castro Hernández C, Herrera Montalvo LA, Díaz-Negrete DB, and Reynoso-Noverón N
- Abstract
Marijuana ( Cannabis sp.) is among the most recurred controlled substances in the world, and there is a growing tendency to legalize its possession and use; however, the genotoxic effects of marijuana remain under debate. A clear definition of marijuana's genotoxic effects remains obscure by the simultaneous consumption of tobacco and other recreational substances. In order to assess the genotoxic effects of marijuana and to prevent the bias caused by the use of substances other than cannabis, we recruited marijuana users that were sub-divided into three categories: (1) users of marijuana-only (M), (2) users of marijuana and tobacco (M+T), and (3) users of marijuana plus other recreative substances or illicit drugs (M+O), all the groups were compared against a non-user control group. We quantified DNA damage by detection of γH2AX levels and quantification of micronuclei (MN), one of the best-established methods for measuring chromosomal DNA damage. We found increased levels of γH2AX in peripheral blood lymphocytes from the M and M+T groups, and increased levels of MNs in cultures from M+T group. Our results suggest a DNA damage increment for M and M+T groups but the extent of chromosomal damage (revealed here by the presence of MNs and NBuds) might be related to the compounds found in tobacco. We also observed an elevated nuclear division index in all marijuana users in comparison to the control group suggesting a cytostatic dysregulation caused by cannabis use. Our study is the first in Mexico to assess the genotoxicity of marijuana in mono-users and in combination with other illicit drugs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Fabian-Morales, Fernández-Cáceres, Gudiño, Andonegui Elguera, Torres-Arciga, Escobar Arrazola, Tolentino García, Alfaro Mora, Oliva-Rico, Cáceres Gutiérrez, Domínguez Ortíz, Castro Hernández, Herrera Montalvo, Díaz-Negrete and Reynoso-Noverón.)
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- 2021
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13. Emergence and spread of the potential variant of interest (VOI) B.1.1.519 of SARS-CoV-2 predominantly present in Mexico.
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Rodríguez-Maldonado AP, Vázquez-Pérez JA, Cedro-Tanda A, Taboada B, Boukadida C, Wong-Arámbula C, Nuñez-García TE, Cruz-Ortiz N, Barrera-Badillo G, Hernández-Rivas L, López-Martínez I, Mendoza-Vargas A, Reyes-Grajeda JP, Alcaraz N, Peñaloza-Figueroa F, Gonzalez-Barrera D, Rangel-DeLeon D, Herrera-Montalvo LA, Mejía-Nepomuceno F, Hernández-Terán A, Mújica-Sánchez M, Becerril-Vargas E, Martínez-Orozco JA, Pérez-Padilla R, Salas-Hernández J, Sanchez-Flores A, Isa P, Matías-Florentino M, Ávila-Ríos S, Muñoz-Medina JE, Grajales-Muñiz C, Salas-Lais AG, Santos Coy-Arechavaleta A, Hidalgo-Miranda A, Arias CF, and Ramírez-González JE
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- COVID-19 transmission, Genome, Viral genetics, Humans, Mexico epidemiology, Mutation, Phylogeny, Prevalence, SARS-CoV-2 classification, SARS-CoV-2 isolation & purification, Spike Glycoprotein, Coronavirus genetics, COVID-19 epidemiology, COVID-19 virology, SARS-CoV-2 genetics
- Abstract
SARS-CoV-2 variants emerged in late 2020, and at least three variants of concern (B.1.1.7, B.1.351, and P1) have been reported by WHO. These variants have several substitutions in the spike protein that affect receptor binding; they exhibit increased transmissibility and may be associated with reduced vaccine effectiveness. In the present work, we report the identification of a potential variant of interest, harboring the mutations T478K, P681H, and T732A in the spike protein, within the newly named lineage B.1.1.519, that rapidly outcompeted the preexisting variants in Mexico and has been the dominant virus in the country during the first trimester of 2021., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
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- 2021
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14. SARS-CoV-2 Infection Rate in Patients With Cancer and Health Care Workers in a Chemoradiotherapy Unit During the Pandemic: A Prospective Cohort in Mexico.
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Meneses-Medina MI, Hernandez-Felix JH, Anaya-Sánchez LG, Valenzuela-Vidales AK, Rosas-Camargo V, Martos-Armendariz EO, Torres-Valdiviezo LI, Cedro-Tanda A, Noguez-Ramos A, Herrera-Montalvo LA, Hidalgo-Miranda A, Valdez-Echeverria RD, Galindo-Fraga A, and Huitzil-Meléndez FD
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- Chemoradiotherapy adverse effects, Health Personnel, Humans, Mexico epidemiology, Pandemics, Prospective Studies, SARS-CoV-2, COVID-19, Neoplasms epidemiology
- Abstract
Purpose: Cancer treatment during the COVID-19 pandemic represents a challenge. Hospital visits to receive treatment and interaction with health care workers (HCW) represent potential contagious events. We aimed to determine SARS-CoV-2 infection rate among patients with cancer and HCW of a chemoradiotherapy unit localized in a center designated as a COVID-19 priority facility in Mexico City. We also determined the diagnostic performance of a clinical questionnaire (CQ) as a screening tool and anti-SARS-CoV-2 antibody seroconversion rate., Methods: HCW and patients with solid tumors attending the chemoradiotherapy unit signed informed consent. To determine SARS-CoV-2 infection rate prospectively, a nasopharyngeal swab for SARS-CoV-2 real-time quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) was performed every 2 weeks in asymptomatics. An electronic CQ interrogating COVID-19-related symptoms was sent daily. Anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies were measured at baseline and at the end of the study period., Results: From June to September 2020, we included 130 asymptomatic participants, 44.6% HCW and 55.4% patients with cancer. During a median follow-up of 85 days, 634 nasopharyngeal swabs were performed. Average SARS-CoV-2 monthly incidence was 4.6% (3.15%-7.47%), and cumulative infection rate was 13.8% (18 of 130). Cases were mostly asymptomatic (66%), and no hospitalizations or deaths were recorded. The CQ as a screening tool provided a sensitivity of 27.7%, a positive predictive value of 26.3%, and a positive likelihood ratio of 12. SARS-CoV-2 IgG seroconversion rate was 27.7% among those with a positive RT-PCR., Conclusion: Patients with cancer on treatment can have uncomplicated COVID-19 outcomes. Biweekly RT-qPCR testing detects asymptomatic infections, prevents transmission, and should be implemented in units to increase patient safety. CQ increase RT-qPCR diagnostic yield and may prioritize testing in resource-deprived settings. Post-infection IgG seroconversion is unreliable., Competing Interests: Monica Isabel Meneses-MedinaHonoraria: Roche, MSDConsulting or Advisory Role: MSD, AstraZeneca (I)Speakers' Bureau: AstraZeneca (I)Research Funding: AstraZeneca (I)Other Relationship: Lilly, Roche (I), Amgen (I), AstraZeneca (I) Vanessa Rosas-CamargoHonoraria: Lilly, Roche Alejandro Noguez-RamosSpeakers' Bureau: IPSENTravel, Accommodations, Expenses: Pfizer Fidel David Huitzil-MeléndezConsulting or Advisory Role: MSD, AstraZenecaHonoraria: MSD, Roche (I)Speakers' Bureau: AstraZenecaResearch Funding: AstraZenecaOther Relationship: Roche, Amgen, AstraZeneca, Lilly (I)No other potential conflicts of interest were reported.
- Published
- 2021
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15. Landscape of Germline Genetic Variants in AGT, MGMT, and TP53 in Mexican Adult Patients with Astrocytoma.
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Carlos-Escalante JA, Gómez-Flores-Ramos L, Bian X, Perdomo-Pantoja A, de Andrade KC, Mejía-Pérez SI, Cacho-Díaz B, González-Barrios R, Reynoso-Noverón N, Soto-Reyes E, Sánchez-Correa TE, Guerra-Calderas L, Yan C, Chen Q, Castro-Hernández C, Vidal-Millán S, Taja-Chayeb L, Gutiérrez O, Álvarez-Gómez RM, Gómez-Amador JL, Ostrosky-Wegman P, Mohar-Betancourt A, Herrera-Montalvo LA, Corona T, Meerzaman D, and Wegman-Ostrosky T
- Subjects
- Adult, Astrocytoma epidemiology, Astrocytoma pathology, Brain Neoplasms epidemiology, Brain Neoplasms pathology, Case-Control Studies, Cohort Studies, Female, Gene Expression Regulation, Neoplastic genetics, Humans, Male, Mexico epidemiology, Middle Aged, Angiotensinogen genetics, Astrocytoma genetics, Brain Neoplasms genetics, DNA Modification Methylases genetics, DNA Repair Enzymes genetics, Genetic Variation genetics, Tumor Suppressor Protein p53 genetics, Tumor Suppressor Proteins genetics
- Abstract
Astrocytoma is the most common type of primary brain tumor. The risk factors for astrocytoma are poorly understood; however, germline genetic variants account for 25% of the risk of developing gliomas. In this study, we assessed the risk of astrocytoma associated with variants in AGT, known by its role in angiogenesis, TP53, a well-known tumor suppressor and the DNA repair gene MGMT in a Mexican population. A case-control study was performed in 49 adult Mexican patients with grade II-IV astrocytoma. Sequencing of exons and untranslated regions of AGT, MGMT, and TP53 from was carried in an Ion Torrent platform. Individuals with Mexican Ancestry from the 1000 Genomes Project were used as controls. Variants found in our cohort were then assessed in a The Cancer Genome Atlas astrocytoma pan-ethnic validation cohort. Variants rs1926723 located in AGT (OR 2.74, 1.40-5.36 95% CI), rs7896488 in MGMT (OR 3.43, 1.17-10.10 95% CI), and rs4968187 in TP53 (OR 2.48, 1.26-4.88 95% CI) were significantly associated with the risk of astrocytoma after multiple-testing correction. This is the first study where the AGT rs1926723 variant, TP53 rs4968187, and MGMT rs7896488 were found to be associated with the risk of developing an astrocytoma.
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- 2021
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16. Cryptorchidism and Testicular Tumor: Comprehensive Analysis of Common Clinical Features and Search of SNVs in the KIT and AR Genes.
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Landero-Huerta DA, Vigueras-Villaseñor RM, Yokoyama-Rebollar E, García-Andrade F, Rojas-Castañeda JC, Herrera-Montalvo LA, Díaz-Chávez J, Pérez-Añorve IX, Aréchaga-Ocampo E, and Chávez-Saldaña MD
- Abstract
Allelic variants in genes implicated in the development of testicular germ cell tumor (TGCT) could be present in patients with cryptorchidism (CO). Currently; the mechanisms explaining this relationship are still unknown. In this study the common clinical features in patients with CO and TGCT and 6 variants of KIT and AR genes associated to TGCT were analyzed. Population analyzed included 328 individuals: 91 patients with CO; 79 with TGCT, 13 of them with previous CO diagnosis, and 158 healthy males. Of the 13 patients with TGCT and history of CO, one patient (7.7%) presented the heterozygous form of the variant rs121913507 and two patients (15.4%) presented homozygote genotype for the variant rs121913506 in KIT gene. Interestingly, the heterozygous form for the variant rs121913506 of KIT gene was identifying in all of 13 patients. The rs201934623, rs774171864, and rs12014709 variants of the AR gene did not show any clinical association. Our results strongly support that genetic component in CO could be conditioning for the development of TGCT. Notably, KIT gene variants might be determinants in the pathological association between TGCT and CO., (Copyright © 2020 Landero-Huerta, Vigueras-Villaseñor, Yokoyama-Rebollar, García-Andrade, Rojas-Castañeda, Herrera-Montalvo, Díaz-Chávez, Pérez-Añorve, Aréchaga-Ocampo and Chávez-Saldaña.)
- Published
- 2020
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17. Tumor microenvironment differences between primary tumor and brain metastases.
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Cacho-Díaz B, García-Botello DR, Wegman-Ostrosky T, Reyes-Soto G, Ortiz-Sánchez E, and Herrera-Montalvo LA
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- Carcinogenesis, Endothelial Cells, Humans, Neovascularization, Pathologic, Brain Neoplasms, Tumor Microenvironment
- Abstract
The present review aimed to discuss contemporary scientific literature involving differences between the tumor microenvironment (TME) in melanoma, lung cancer, and breast cancer in their primary site and TME in brain metastases (BM). TME plays a fundamental role in the behavior of cancer. In the process of carcinogenesis, cells such as fibroblasts, macrophages, endothelial cells, natural killer cells, and other cells can perpetuate and progress carcinogenesis via the secretion of molecules. Oxygen concentration, growth factors, and receptors in TME initiate angiogenesis and are examples of the importance of microenvironmental conditions in the performance of neoplastic cells. The most frequent malignant brain tumors are metastatic in origin and primarily originate from lung cancer, breast cancer, and melanoma. Metastatic cancer cells have to adhere to and penetrate the blood-brain barrier (BBB). After traversing BBB, these cells have to survive by producing various cytokines, chemokines, and mediators to modify their new TME. The microenvironment of these metastases is currently being studied owing to the discovery of new therapeutic targets. In these three types of tumors, treatment is more effective in the primary tumor than in BM due to several factors, including BBB. Understanding the differences in the characteristics of the microenvironment surrounding the primary tumor and their respective metastasis might help improve strategies to comprehend cancer.
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- 2020
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18. Mexican BRCA1 founder mutation: Shortening the gap in genetic assessment for hereditary breast and ovarian cancer patients.
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Fragoso-Ontiveros V, Velázquez-Aragón JA, Nuñez-Martínez PM, de la Luz Mejía-Aguayo M, Vidal-Millán S, Pedroza-Torres A, Sánchez-Contreras Y, Ramírez-Otero MA, Muñiz-Mendoza R, Domínguez-Ortíz J, Wegman-Ostrosky T, Bargalló-Rocha JE, Gallardo-Rincón D, Reynoso-Noveron N, Arriaga-Canon C, Meneses-García A, Herrera-Montalvo LA, and Alvarez-Gomez RM
- Subjects
- Adult, Breast Neoplasms diagnosis, Exons genetics, Family Health, Female, Founder Effect, Genetic Testing, Humans, Mexico, Middle Aged, Ovarian Neoplasms diagnosis, Sequence Deletion, Young Adult, BRCA1 Protein genetics, Breast Neoplasms genetics, Genetic Predisposition to Disease genetics, Germ-Line Mutation, Ovarian Neoplasms genetics
- Abstract
The deletion of exons 9 to 12 of BRCA1 (9-12 del BRCA1) is considered a founder mutation in the Mexican population. We evaluate the usefulness of the target detection of 9-12 del BRCA1 as the first molecular diagnostic strategy in patients with Hereditary Breast and Ovarian Cancer (HBOC). We performed the genetic assessment of 637 patients with suspected HBOC. The region corresponding to the breakpoints for the 9-12 del BRCA1 was amplified by polymerase chain reaction (PCR). An analysis of the clinical data of the carriers and non-carriers was done, searching for characteristics that correlated with the deletion. The 9-12 del BRCA1 was detected in 5% of patients with suspected HBOC (30/637). In patients diagnosed with ovarian cancer, 13 of 30 were 9-12 del BRCA1 carriers, which represents 43%. We found a significant association between the 9-12 del BRCA1 carriers with triple negative breast cancer and high-grade papillary serous ovarian cancer. We concluded that the detection of the 9-12 del BRCA1 is useful as a first molecular diagnostic strategy in the Mexican population. In particular, it shortens the gap in genetic assessment in patients with triple negative breast cancer and ovarian cancer., Competing Interests: The authors have declared that no competing interest exist.
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- 2019
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19. Prevalence of germline mutations in the TP53 gene in patients with early-onset breast cancer in the Mexican population.
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Gallardo-Alvarado LN, Tusié-Luna MT, Tussié-Luna MI, Díaz-Chávez J, Segura YX, Bargallo-Rocha E, Villarreal C, Herrera-Montalvo LA, Herrera-Medina EM, and Cantu-de Leon DF
- Subjects
- Adult, Age Factors, Breast Neoplasms epidemiology, Breast Neoplasms pathology, Female, Genetic Association Studies, Genetic Variation, Humans, Li-Fraumeni Syndrome epidemiology, Li-Fraumeni Syndrome genetics, Mexico epidemiology, Pedigree, Prevalence, Young Adult, Breast Neoplasms genetics, Genes, p53 genetics, Genetic Predisposition to Disease genetics, Germ-Line Mutation genetics
- Abstract
Background: Heterozygous germline TP53 gene mutations result in Li-Fraumeni Syndrome (LFS). Breast cancer (BC) is the most frequent tumor in young women with LFS. An important issue related to BC in the Mexican population is the average age at diagnosis, which is approximately 11 years younger than that of patients in the United States (U.S.) and Europe. The aim of this study was to determine the prevalence of germline mutations in TP53 among young Mexican BC patients., Methods: We searched for germline mutations in the TP53 gene using targeted next-generation sequencing (NGS) in 78 BC patients younger than 45 years old (yo) who tested negative for BRCA1/2 mutations. A group of 509 Mexican women aged 45yo or older without personal or family BC history (parents/grandparents) was used as a control., Results: We identified five patients with pathogenic variants in the TP53 gene, equivalent to 6.4% (5/78). Among patients diagnosed at age 36 or younger, 9.4% (5/55) had pathogenic TP53 mutations. Three of these variants were missense mutations (c.844C > T, c.517G > A, and c.604C > T), and the other two mutations were frameshifts (c.291delC and c.273dupC) and had not been reported previously. We also identified a variant of uncertain clinical significance (VUS), c.672G > A, which causes a putative splice donor site mutation. All patients with TP53 mutations had high-grade and HER2-positive tumors. None of the 509 patients in the healthy control group had mutations in TP53., Conclusions: Among Mexican BC patients diagnosed at a young age, we identified a high proportion with germline mutations in the TP53 gene. All patients with the TP53 mutations had a family history suggestive of LFS. To establish the clinical significance of the VUS found, additional studies are needed. Pathogenic variants of TP53 may explain a substantial fraction of BC in young women in the Mexican population. Importantly, none of these mutations or other pathological variants in TP53 were found in the healthy control group.
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- 2019
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20. Angiotensinogen rs5050 germline genetic variant as potential biomarker of poor prognosis in astrocytoma.
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Perdomo-Pantoja A, Mejía-Pérez SI, Reynoso-Noverón N, Gómez-Flores-Ramos L, Soto-Reyes E, Sánchez-Correa TE, Guerra-Calderas L, Castro-Hernandez C, Vidal-Millán S, Sánchez-Corona J, Taja-Chayeb L, Gutiérrez O, Cacho-Diaz B, Alvarez-Gomez RM, Gómez-Amador JL, Ostrosky-Wegman P, Corona T, Herrera-Montalvo LA, and Wegman-Ostrosky T
- Subjects
- Adult, Aged, Angiotensinogen blood, Astrocytoma mortality, Astrocytoma therapy, Biomarkers, Tumor genetics, Brain Neoplasms mortality, Brain Neoplasms therapy, Female, Follow-Up Studies, Gene Frequency, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Pilot Projects, Prognosis, Prospective Studies, Survival Analysis, Young Adult, Angiotensinogen genetics, Astrocytoma diagnosis, Astrocytoma genetics, Brain Neoplasms diagnosis, Brain Neoplasms genetics, Germ-Line Mutation
- Abstract
Introduction: Renin-angiotensin system (RAS) in brain cancer represents a scarcely explored field in neuro-oncology. Recently, some pre- and clinical studies have reported that RAS components play a relevant role in the development and behavior of gliomas. The angiotensinogen (AGT) rs5050 genetic variant has been identified as a crucial regulator of the transcription of AGT mRNA, which makes it a logical and promising target of research. The aim of this study was to determine the relationship between the AGT rs5050 genetic variant in blood with prognosis in astrocytoma., Methods: A prospective pilot study was performed on forty-eight astrocytoma patients, who received the standard-of-care treatment. Blood samples were taken prior to surgery and DNA was sequenced using Ion Torrent next-generation sequencing and analyzed by Ion Reporter software. Descriptive, bivariate, multivariate, and survival analyses were performed using SPSS v21, STATA 12 and GraphPad Prism 7., Results: Median follow-up was 41 months (range 1-48). Survival analysis showed a significant difference between the rs5050 genotypes (p = .05). We found lower survival rates in individuals with the GG-genotype of rs5050 AGT compared to patients with the TT- and TG-genotype (2 months vs. 11.5 months, respectively [p = .01]). In bivariate and multivariate analyses, GG-genotype was negatively associated with survival., Conclusions: In patients with astrocytoma, AGT rs5050 GG-genotype was associated with poor prognosis. We propose this germline genetic variant as a complementary biomarker, which can be detected practically and safely in blood samples or saliva., Competing Interests: The authors have declared that no competing interests exist.
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- 2018
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21. Histology as Prognostic Factor in Early-Stage Cervical Carcinoma. Experience in a Third-Level Institution.
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Barquet-Muñoz SA, Cruz-Rodríguez E, Cantú De León DF, Isla-Ortiz D, Montalvo-Esquivel G, Herrera-Montalvo LA, Pérez-Plasencia C, Pérez-Montiel D, and Herrera-Gómez Á
- Subjects
- Adenocarcinoma epidemiology, Adult, Carcinoma, Adenosquamous epidemiology, Carcinoma, Squamous Cell epidemiology, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Mexico, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Uterine Cervical Neoplasms epidemiology, Adenocarcinoma pathology, Carcinoma, Adenosquamous pathology, Carcinoma, Squamous Cell pathology, Uterine Cervical Neoplasms pathology
- Abstract
Background: Cervical carcinoma (CC) is one of the most frequent neoplasms, especially in developing countries. The most common histopathological type is squamous cell carcinoma (SCC), followed by adenocarcinoma (AC) and adenosquamous carcinoma (ASC). Prognosis according to histological type is controversial., Objective: The objective of this study is to describe and compare the prognoses of the most common histologies of CC in the early stages., Materials and Methods: We reviewed records of patients attended at the Instituto Nacional de Cancerología of Mexico with CC surgically treated Stages IA2-IB1 and IIA1, including the histological types SCC, AC, and ASC. Patients who had another malignant neoplasm, cervical cancer in situ, locally advanced neoplasm, and metastatic neoplasm were excluded from the study. A descriptive and comparative analysis was conducted. Overall survival (OS) and disease-free period were calculated for each histological type with the Kaplan-Meier method and were compared with the log-rank test., Results: A total of 202 records were obtained, of which 131 (64.9%) had SCC, 57 (28.2%) AC, and 14 (6.9%) ASC. The 5-year DFS was 94.4% for SCC, 98.1% for AC, and 92.3% for ASC, without a statistically significant difference (p = 0.55). The 5-year OS for SCC was 97.9%, for AC was 97.8%, and for ASC was 100%, without a statistically significant difference (p = 0.702)., Conclusions: DFS and OS did not differ between the most common histological types of CC at the early stages.
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- 2017
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22. Role of pelvic and para-aortic lymphadenectomy in abandoned radical hysterectomy in cervical cancer.
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Barquet-Muñoz SA, Rendón-Pereira GJ, Acuña-González D, Peñate MV, Herrera-Montalvo LA, Gallardo-Alvarado LN, Cantú-de León DF, and Pareja R
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- Adenocarcinoma pathology, Adult, Aorta pathology, Carcinoma, Squamous Cell pathology, Female, Follow-Up Studies, Humans, Immunoenzyme Techniques, Middle Aged, Neoplasm Grading, Neoplasm Staging, Pelvic Neoplasms pathology, Prognosis, Retrospective Studies, Survival Rate, Uterine Cervical Neoplasms pathology, Adenocarcinoma surgery, Aorta surgery, Carcinoma, Squamous Cell surgery, Hysterectomy mortality, Lymph Node Excision mortality, Pelvic Neoplasms surgery, Uterine Cervical Neoplasms surgery
- Abstract
Background: Cervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment. The objective of this study is to compare the prognosis of patients with CC whom RH was abandoned and bilateral pelvic lymphadenectomy and para-aortic lymphadenectomy was performed with that of patients who were only biopsied or with removal of a suspicious lymph node, treated with concomitant radiotherapy/chemotherapy in the standard manner., Methods: A descriptive and retrospective study was conducted in two institutions from Mexico and Colombia. Clinical records of patients with early-stage CC programmed for RH with an intraoperative finding of pelvic lymph, para-aortic nodes, or any extracervical involvement that contraindicates the continuation of surgery were obtained. Between January 2007 and December 2012, 42 clinical patients complied with study inclusion criteria and were selected for analysis., Results: In patients with CC whom RH was abandoned due to lymph node affectation, there is no difference in overall survival or in disease-free period between systematic lymphadenectomy and tumor removal or lymph node biopsy, in pelvic lymph nodes as well as in para-aortic lymph nodes, when these patients receive adjuvant treatment with concomitant radiotherapy/chemotherapy., Conclusions: This is a hypothesis-generator study; thus, the recommendation is made to conduct randomized prospective studies to procure better knowledge on the impact of bilateral pelvic and para-aortic lymphadenectomy on this group of patients.
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- 2017
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23. Clinical prognostic factors in adults with astrocytoma: Historic cohort.
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Wegman-Ostrosky T, Reynoso-Noverón N, Mejía-Pérez SI, Sánchez-Correa TE, Alvarez-Gómez RM, Vidal-Millán S, Cacho-Díaz B, Sánchez-Corona J, Herrera-Montalvo LA, and Corona-Vázquez T
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- Adult, Aged, Astrocytoma mortality, Brain Neoplasms mortality, Cohort Studies, Female, Humans, Male, Mexico epidemiology, Middle Aged, Astrocytoma epidemiology, Brain Neoplasms epidemiology
- Abstract
Objective: To explore the clinical prognostic factors for adults affected with astrocytoma., Patients and Methods: Using a historic cohort, we selected 155 clinical files from patients with astrocytoma using simple randomization. The main outcome variable was overall survival time. To identify clinical prognostic factors, we used bivariate analysis, Kaplan Meier, the log rank test and the Cox regression models. The number of lost years lived with disability (DALY) based on prevalence, was calculated., Results: The mean age at diagnosis was 45.7 years. Analysis according to tumour stage, including grades II, III and IV, also showed a younger age of presentation. Kaplan-Meier survival estimates showed that tumour grade, Karnofsky status (KPS) ≥70, resection type, chemotherapy, radiotherapy, alcohol consumption, familial history of cancer and clinical presentation were significantly associated with survival time. Using a proportional hazard model, age, grade IV, resection, chemotherapy+radiotherapy and KPS were identified as prognostic factors.The amount of life lost due to premature death in this population was 28 years., Conclusion: In our study, astrocytoma was diagnosed in young adults. The overall survival was 15 months, 9% (n=14) of patients presented a survival of 2 years, and 3% of patients survived 3 years. On average the number of years lost due to premature death and disability was 28.53 years., (Copyright © 2016 Elsevier B.V. All rights reserved.)
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- 2016
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24. Metaplastic breast cancer: a comparison between the most common histologies with poor immunohistochemistry factors.
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Barquet-Muñoz SA, Villarreal-Colin SP, Herrera-Montalvo LA, Soto-Reyes E, Pérez-Plasencia C, Coronel-Martínez J, Pérez-Montiel D, Vázquez-Romo R, and Cantú de León D
- Subjects
- Adult, Aged, Breast Neoplasms metabolism, Breast Neoplasms mortality, Breast Neoplasms therapy, Female, Follow-Up Studies, Humans, Immunohistochemistry, Metaplasia, Middle Aged, Mortality, Neoplasm Grading, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasm Staging, Retrospective Studies, Treatment Outcome, Breast Neoplasms pathology
- Abstract
Background: Metaplastic carcinoma of the breast (MCB) is a rare histological type of breast cancer. This study aimed to determine whether MCB exhibits shorter overall survival (OS) and disease-free survival (DFS) compared with other histologies that are considered unfavorable., Methods: We retrospectively analyzed 157 clinical file records of the Mexico City-based National Institute of Cancerology and compared the clinical characteristics and treatment of 24 patients with MCB, 37 patients with triple-negative invasive lobular carcinoma (TN-ILC), 48 patients with high-grade invasive ductal carcinoma (HG-IDC), and 48 patients with triple-negative invasive ductal carcinoma (TN-IDC), paired by clinical stage and age. We performed a comparative analysis and analyzed OS and DFS using a log-rank test., Results: In patients with MCB, the 5-year DFS was 52.1% (mean, 48.52 months; 95%: 35.32-61.72), and the 5-year OS was 72.2% (mean, 59.77 months; 95% CI: 48.55-71.00). No differences were observed in the DFS of MCB compared with each of the other histologies (MCB vs. HG-IDC, p = 0.865; MCB vs. TN-IDC, p = 0.966, and MCB vs. TN-ILC, p = 0.132). Moreover, no differences were observed when comparing the OS of MCB with that of each of the other histologies (MCB vs. HG-IDC, p = 0.246; MCB vs. TN-IDC, p = 0.255, and MCB vs. TN-ILC, p = 0.387)., Conclusions: Neither OS nor DFS differ between patients with MCB and those with other histologies with unfavorable immunohistochemical factors.
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- 2015
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25. [Third National Ovarian Consensus. 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM"].
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Gallardo-Rincón D, Cantú-de-León D, Alanís-López P, Alvarez-Avitia MA, Bañuelos-Flores J, Herbert-Núñez GS, Oñate-Ocaña LF, Pérez-Montiel MD, Rodríguez-Trejo A, Ruvalcaba-Limón E, Serrano-Olvera A, Ortega-Rojo A, Cortés-Esteban P, Erazo-Valle A, Gerson-Cwilich R, De-la-Garza-Salazar J, Green-Renner D, León-Rodríguez E, Morales-Vásquez F, Poveda-Velasco A, Aguilar-Ponce JL, Alva-López LF, Alvarado-Aguilar S, Alvarado-Cabrero I, Aquino-Mendoza CA, Aranda-Flores CE, Bandera-Delgado A, Barragán-Curiel E, Barrón-Rodríguez P, Brom-Valladares R, Cabrera-Galeana PA, Calderillo-Ruiz G, Camacho-Gutiérrez S, Capdeville-García D, Cárdenas-Sánchez J, Carlón-Zárate E, Carrillo-Garibaldi O, Castorena-Roji G, Cervantes-Sánchez G, Coronel-Martínez JA, Chanona-Vilchis JG, Díaz-Hernández V, Escudero-de-los Ríos P, Garibay-Cerdenares O, Gómez-García E, Herrera-Montalvo LA, Hinojosa-García LM, Isla-Ortiz D, Jiménez-López J, Lavín-Lozano AJ, Limón-Rodriguez JA, López-Basave HN, López-García SC, Maffuz-Aziz A, Martínez-Cedillo J, Martínez-López DM, Medina-Castro JM, Melo-Martínez C, Méndez-Herrera C, Montalvo-Esquivel G, Morales-Palomares MA, Morán-Mendoza A, Morgan-Villela G, Mota-García A, Muñoz-González DE, Ochoa-Carrillo FJ, Pérez-Amador M, Recinos-Money E, Rivera-Rivera S, Robles Flores JU, Rojas-Castillo E, Rojas-Marín C, Salas-Gonzáles E, Sámano-Nateras L, Santibañez-Andrade M, Santillán-Gómez A, Silva-García A, Silva JA, Solorza-Luna G, Tabarez-Ortiz AR, Talamás-Rohana P, Tirado-Gómez LL, Torres-Lobatón A, and Quijano-Castro F
- Subjects
- Aftercare, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Adjuvant, Combined Modality Therapy, Drug Resistance, Neoplasm, Early Diagnosis, Female, Genes, Neoplasm, Humans, Laparoscopy, Lymph Node Excision, Neoadjuvant Therapy, Neoplasm Staging standards, Neoplastic Syndromes, Hereditary genetics, Omentum surgery, Organoplatinum Compounds administration & dosage, Ovariectomy methods, Palliative Care, Quality of Life, Radiotherapy, Adjuvant, Salvage Therapy, Taxoids administration & dosage, Ovarian Neoplasms diagnosis, Ovarian Neoplasms epidemiology, Ovarian Neoplasms genetics, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy
- Abstract
Introduction: Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia., Material and Methods: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members., Results: No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically., Conclusions: In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.
- Published
- 2011
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